ASTRAZENECA PATIENT SAVINGS PROGRAMS FOR SPECIALTY PRODUCTS

HOW THE PROGRAMS WORK?

You may be contacted by a pharmacy or healthcare provider informing you that there will be an out-of-pocket cost for the product you have been prescribed.

If you meet the program eligibility requirements, ask to be enrolled in the Patient Savings Program. You can also enroll yourself by contacting AstraZeneca Access 360TM at 1-844-ASK-A360(1-844-275-2360).(1-844-275-2360).

If you meet the program eligibility criteria, a Patient Savings Program account will be created for you.

You will pay a set amount of your out-of-pocket costs, based on the product, and your pharmacy or healthcare provider will submit a claim to the Patient Savings Program to cover the balance, up to the program maximum. See details below.

HOW THE PROGRAMS WORK:

You may be contacted by a pharmacy or healthcare provider informing you that there will be an out-of-pocket cost for the product you have been prescribed.

If you meet the program eligibility requirements, ask to be enrolled in the Patient Savings Program. You can also enroll yourself by contacting AstraZeneca Access 360TM at 1-844-ASK-A360 (1-844-275-2360).(1-844-275-2360).

If you meet the program eligibility criteria, a Patient Savings Program account will be created for you.

You will pay a set amount of your out-of-pocket costs, based on the product, and your pharmacy or healthcare provider will submit a claim to the Patient Savings Program to cover the balance, up to the program maximum. See details below.

DETAILS FOR PROGRAMS

Patient pays $0 per 30-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year

Patient pays $0 per injection, program pays remaining out-of-pocket costs up to a maximum of $10,000 per calendar year. The out-of-pocket costs covered by the program can include the cost of the product itself and/or the cost of injection administration of the product (program maximum of $100 per injection administration assistance)††Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for injection administration assistance.

Patient pays $0 per infusion, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year. The out-of-pocket costs covered by the program can include the cost of the product itself and/or the cost of infusion of the product (program maximum of $100 per infusion assistance)**Patients who are residents of Massachusetts, Michigan, Minnesota, or Rhode Island are not eligible for infusion assistance.